CaPSulAR
Research type
Research Study
Full title
Investigating the mechanisms of early post-stroke shoulder pain associated with restriction of shoulder external rotation Acronym; CaPSulAR (Causes of Post Stroke Shoulder Pain Associated with Restricted External Rotation)
IRAS ID
227171
Contact name
Gemma Jones
Contact email
Sponsor organisation
University College London
Clinicaltrials.gov Identifier
Z6364106/2017/12/47 , UCL Data Protection Registration Number
Duration of Study in the UK
1 years, 6 months, 0 days
Research summary
Pain in the shoulder is a common problem after stroke. As well as causing distress through pain and lost sleep, it prevents rehabilitation of the arm and hand. There are guidelines on how to deal with post-stroke shoulder pain, but some healthcare professionals think they are unhelpful. We believe that this is because not enough attention is paid to the underlying causes of the pain. If we don’t know the cause of someone’s pain then it is very difficult to choose the correct treatment. In this proposal, we focus on people with painful shoulders who also have a restriction in how far the shoulder can be moved in a particular direction, called ‘external rotation’. These people often have their affected arm pulled into and across their body. We believe that there are two main causes of this presentation, (i) restriction in the joint capsule, called ‘adhesive capsulitis’ or frozen shoulder, or (ii) abnormal muscular overactivity in certain shoulder muscles called ‘spasticity’. Each of these has a very different type of treatment, and we argue that early identification of the cause of post-stroke shoulder pain is crucial to ensure each patient is treated correctly. In this study, we will recruit participants at risk of developing shoulder pain within the first week after stroke. We will follow them up for 8 weeks and record both the onset of shoulder pain, and when they lose 10 degrees of shoulder external rotation. Adhesive capsulitis or spasticity will be diagnosed with clinical assessments combined with ultrasound and or needle insertion muscle testing respectively, telling us how common each one is and helping to identify clinical features that will allow us to identify these problems prior to pain. This work will identify ‘who’, ‘when’ and ‘how’ to treat people with painful shoulders after stroke more effectively.
REC name
London - Dulwich Research Ethics Committee
REC reference
18/LO/0225
Date of REC Opinion
27 Feb 2018
REC opinion
Favourable Opinion